OBJECTIVES: To examine the economic burden and treatment patterns of chronic kidney disease (CKD) in the U.S. veteran population. METHODS:   A retrospective database analysis was performed using the Veterans Health Administration (VHA) Medical SAS Datasets from October 1, 2005 to May 31, 2012. Patients diagnosed with CKD were identified using International Classification of Disease 9thRevision Clinical Modification (ICD-9-CM) diagnosis codes 585.xx, 250.4xx, 791.0x, 583.xx, and 403.xx. Descriptive statistics were calculated as means ± standard deviation (SD) and percentages to measure treatment patterns, costs and utilization distribution in the sample. Treatment patterns were examined 60 days after the identification date, and costs and utilization were examined for the 1-year follow-up period. RESULTS:   The total number of U.S. veterans diagnosed with CKD in the VHA study population from 2005 to 2012 was 433,771. The top treatments for CKD patients were simvastatin (n=159,532, 36.78%), lisinopril (n=135,660, 31.27%), omeprazole (n=93,449, 21.54%) and furosemide (n=90,114, 20.77%). Other treatments included insulin, metoprolol tartrate, and amlodipine besylate, all of which showed less than 20% of patient use. The top two comorbidities for CKD patients were hypertension and diabetes. The percentage of patients with follow-up inpatient visits was 27.23%, which translated into $11,927 in inpatient visit costs per patient. The percentage of patients with follow-up outpatient visits was 99.56%, incurring $8614 in outpatient costs per patient. Patients with pharmacy visits (94.61%) incurred $1869 in pharmacy costs. The average number of CKD patients with blood urea nitrogen test results was 349,750 (80.63%), and the test result mean was 27.01. The average number of CKD patients with creatinine estimated Glomerular Filtration Rate (eGFR) test results was 243,774 (56.20%) and the result mean was 50.67. CONCLUSIONS:   Inpatient costs for CKD patients were responsible for more than half of the total costs. Laboratory test results should always be considered when interpreting drug effects.